Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

Wednesday, June 04, 2008

Linking the Anechoic Effect and Suppression of Research to Conflicts of Interest and Mission-Hostile Management: the VCU Case

We recently discussed ties between Virginia Commonwealth University (VCU) and the tobacco industry. Here we discussed how the university got a grant which gave proprietary control of any research results to the sponsor, Philip Morris, a tobacco company, not the academic researcher, and required the grant itself to be secret. Here we discussed issues raised by the university president's position on the board of directors of another tobacco company, Universal Corporation.

Virginia Commonwealth University researchers and faculty who fear reprisal for speaking out against a secret smoke-filled-room research agreement between the school and Philip Morris USA are taking extraordinary steps to protect themselves.

A form letter, which many say they plan to sign and send to the university’s Human Resources Department, is being circulated via e-mail that states 'on the record that I am concerned about a May 22nd New York Times report' about the Philip Morris research agreement’s covenants that restrict publication and use of research findings in violation of university policy.

The letter cites a fear of retaliation 'if I openly express my concerns,' and its purpose is 'to document and date this apprehension in case action is later taken against me that could be linked to a decision to voice my disapproval .…'

According to numerous VCU faculty and staff members, the letter is the only protection they feel they have against the possibility of unfair treatment for speaking out about what they consider a clear violation of research ethics. While it’s unclear how many faculty members are contemplating signing the form letter, Style Weekly has interviewed half a dozen faculty members and researchers who say they plan to sign it.

They all spoke on the condition of anonymity.

'Part of the paranoia comes from seeing what already has come to pass,' one high-level researcher on federal grant projects says of 'senior people at VCU' who have left because of the Philip Morris deal. 'We’ve all come to the conclusion that the potential risks from [signing the letter] are minimal compared to the risks of not doing it.'

The article also alleged that some of the fear may be due to the possibility that the university will soon have much larger ties to the tobacco industry than have been heretofore revealed.

A pending proposal, highlighted at various meetings by Jerome Strauss, dean of the VCU School of Medicine, could link federal grant funds with 'several million dollars' — initially about $30 million, but since scaled back — directly from Philip Morris for the creation of a women’s health center. Numerous college sources cited the deal, with one providing details that included in an early draft proposal for the center.

The tentatively named Philip Morris Women’s Health Center would examine disparities between women’s health care and other areas of health care, but according to one source, Strauss has said the exact focus could be affected depending on Philip Morris’ participation.

This case now illustrates the inter-relationships of several topics we commonly discuss on Health Care Renewal: conflicts of interest affecting health care decisionmakers, suppression of research, and the anechoic effect. To look at it another way, it shows academic medical institutions lead by the conflicted are prone to take actions hostile to their clinical and academic missions.

So as I wrote in my last post, this case too makes a striking argument for the need to drastically reform the leadership and governance of health care organizations, and academic medical centers in particular.

I wonder what the breakdown was of the $600K (100K gift + 500K transplant) that went to UCLA (see Gangster post) in terms of sources. How many of those dollars came from prostitution, illegal drugs, murder payments, gambling, theft and bribery? Or interest earned on these latter endeavors? And UCLA put a placard up to boot in order to honor the "source".

Lucifer must be expanding his file cabinets to accommodate the ever expanding contracts...

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